Alaa Prometric
Alaa Prometric
Newborn baby had VSD andoperation was done at the age of 18 yrs old. The
propability of VSD in the current pregnancy is:
a-0.5%
b-2%
c-40%
d-???
***it was 3.5% in case of one child previously affected
and 4.5% with 2 children and 5% if mother its self has
congenital HD and 7% if father affected
female with history of Post partum Hge with failure of lactation .Now she has
amenorrhea and infertility.ttt:
a-dopamine
b-gonadotropins
c-clomide
Lateral vulvar growth 1.5 cm in 70 years old pt. Without lymph node
metadtasis
.Wide local excision
.Radical vulvectomy with1.5 cm sfety with epsilateral inguino femoral lymphadenectomy
.radical vulvectomy with 0.5 cm free margin with epsilateral inguinofemoral
lymphadenectomy
Local excision with epsilateral inguinofemoral lymphadenectomy.
70 yrs old
Presented with post menopausal bleeding cervix healthy
Most likely cause :
atrophic vaginitis
PG at 40 weeks
Presented in labour
Continuous uterine contractions FHR 180
Mild Vaginal bleeding
Diagnosis
1.rupture uterus
2.abruptu placentae
Indication of colposcopy
A.routine after cone biopsy
B. High grade squamous intraepithelial neoplasia in 27 years old
C.normal pap smear in patient with history of dysplasia
Pregnant female with cushing syndrome the outcome
Still birth
Preterm labor
Neonatal death
Conjenital malformations
a. 9%
70% ??
which of the following ass with long term use of birth control pills
A.amenorreha
B.HTN
C.DM
D. thrombo embolism
E. Myochardial infaction
Mother coming with her newborn female that has vaginal bleeding
a-reassure the mother
b-do US for the newborn
c-gonadotrophin assay for the newborn
Young female with 1ry infertility. Normal investigation for her and for
husband.clomide was used for one year .ttt:
a-Clomide and IUI
b-IUI
c-IVF
Pregnant female with strict vegetable diet. Deficiency of:
a-vit b12
b-folic acid
c-ca
A pregnant female develops lesions on the vulva and vagina and she
was diagnosed as genital herpes, what should be included in her
future health care?
a. Cesarian section should be done if the lesions did not disappear before 2 weeks of
delivery date
b. Oral acyclovir to treat herpes
c. Termination of pregnancy because of the risk of fetal malformations
d. Avoidance of sexual intercourse for 1 month after the healing of the lesions
****Duplex US = comprsion US
Pregnant woman at 34 wks presented with sever vaginal bleeding. .fetus IUFD
What is next step
1.cs
2.oxytocin
3.IV fluids + blood transfusion
PG at 40 weeks
Presented in labour
Continuous uterine contractions FHR 180
Mild Vaginal bleeding
Diagnosis
1.rupture uterus
2.abruptu placentae
Pt suffer from mild lower abd pain come to emergency room complaining of mild lowe abd
pain and vomiting 3 days ago.pic of us clear seous cyst.most appropriate management:
A.ttt with anti inflammatory drug
B.immediate laparoscopy
C.follow up after 2 weeks
If there is fever A
70 yrs old
Presented with post menopausal bleeding cervix healthy
Most likely cause :
atrophic vaginitis
38 weeks patient with come to emegency room complaining of mild vaginal bleeding the fetus
vertex with معاها صوره فيهاsinusoidal rhythm
a.Immediate c.s.
b.Repeat ctg
c.Fetal blood ph
Obese patient with rabid progressive hirsutism
Fsh normal
Lh. Normal
Testosteron 500 lncreased
Bp bl.suger normal
A.androgen secreting tumor
B.PCO
c.gonadal origin.
Pregnant patient complaining of pruritis with no skin lesion ,normal liver enzymes ,this
condition treated by
.a.ursodeoxycholic acid
b.Cholestyramin
c,Estrogen
Acase of 28 week pregnant complain of pruritis with no skin lesion sever symptoms
Elevated liver enzymes
Elavated direct billirubin
Normal indirect billirubin
This case will deliver at
35_34
38_37
40_39
41_40
wks missed abortion 12
a- misoprstol
b- PGF2
C-OXYTOCIN
pic of laproscopy with bloody lesions on the surface
of the uterus seems to be endometriosis, next to it a
picture while treating these lesions
Question is this procedure is done because of ?
a.Pelvic pain
b.Infection
Girl with headache. PRL 435
Wt. Nxt to do
MRI
Dopamine agonist
Female complaining of regular cyclic abdominal pain.on examination appearance of secondry
sexual characters.on examination there is normal hymen but cannot completely indrntified the
vagina.cause
A.cribtiform hymen
B.longitudinal vaginal septum
C.sptate vagina
D.transverse vaginsl septum
?The most common chromosomal anomalies in aborted fetus
A.autosomal triosmy
B.triploidy
C.tetraploidy
Pt with gestational DM.she checked her glucose level four times per day.she complaining that
glucose level very high after breakfast even after normal fasting glucose level.cause
A.eating heavy meals at night
B.increased induline resistance in the morning
yrs woman nullipara wants to get pregnant came for prenatal counseling , fsh , lh and all 42
hormones were normal and she has no complain
: Your advice is
a.Reassure her
b,IVF
c,IUI
Alpfa feto protin icrease in all except:
a.Down
b.Anencephaly
c.Omphalocele
d.Encephalocele
Gross Body 3 or more discrete body or limb movements Less than 3 body or limb movements in 30
Movement within 30 minutes minutes
One or more episodes of active extension and Slow extension with no return or slow return
Fetal Tone flexion of a fetal extremity OR opening and to flexion of a fetal extremity OR no fetal
closing of the hand within 30 minutes movement
Non-stress test
Reactive Nonreactive
(NST)**
Ceftriaxone
Flouroquiolone
female pt. with typical presentation of trichomons , ttt :
Metronidazole
classical case of candidal infection → itching , white discharge from
: vagina , ttt is
A.Miconazole
B.Amoxicillin
<<< Pt with history of infertility the first line of investigation for this couple is
semen analysis
Female came with hx of sever abdominal pain, vaginal bleeding for 6 hours, -
amenorrhea for 8 wk, , O/E tachycardiac, hypertensive, tense abdomen. what is
:the most likely site of the ectopic pregnancy
a- Fallopian tube
b- Ovary
c- Peritoneum
d- Fimbria
Pt with dysmenorria, infertility, not responding to naproxen, what cauld be the
:cause
a- Endometritis
b- Endometriosis
female with vaginal bleeding , abdominal pain : first Inx :
US
Vaginal Examination
Acanthosis Nigricans associated with :
polycystic ovary syndrome
**(due to insulin resistant)
Elderly female married since 30 years had fever, chills, dysurea, and
:diarrhea. No back pain. The diagnosis is
a) Acute bacterial cystitis
b) Acute pyelonephritis >>In acute
pyelonephritis, the classic triad of fever,
costovertebral angle pain, and nausea and/or
vomiting may be present, although they may not
.necessarily occur together temporally
c) Bacterial gastroenteritis
d) Viral gastroenteritis
Uterovaginal prolapse:
a) Increase heaviness in erect position (correct)
b) More in blacks
c) A common cause of infertility
Pregnant women G4P3+1 on GA 10 wk came to you with IUCD
inserted & the string is out from O.S what is the most important
: measure
a- leave the IUCD & give A.B
b- leave the IUCD & send to Ob/ Gynaecologist to
remove
c- leave the IUCD
.d- do laparoscopy to see if there is ectopic preg
e- Reassurance the pt
: Placenta previa excludes-30
a- Pain less vaginal bleeding
(b- Tone increased of uterus (correct
c- Lower segmental abnormality
d- Early 3rd trimester
Pregnancy test +ve after :
a- a-one day post coital
b- 10 day after loss
menstrual cycle
(correct)>>qualitative
hCG test .Doctors
often order these tests
to confirm pregnancy as
early as 10 days after a
missed period
c- One wk after loss
menstrual cycle
What is the condition that produces malodorous watery vaginal discharge with
+ve clue cells in wet mount preparation slides:
a. Bacterial vaginosis
b. Vaginal Candidiasis
c. Trichomonas vaginalis
d. Gonorrhea
classical characteristic for genital herpes.Painful ulcers & vesicles
A very very long scenario about a female patient with vaginal discharge
“malodorous watery in character” with pH of 6 & +ve clue cells but there is no
branching pseudohyphe. (He is telling you the diagnosis is vaginosis & there is no
fungal infection) Then he asks about which of the following drug regimens
should NOT be used in this paitent:
a. Metronidazole (PO 500 gm for 7 days)
b. Metronidazole (PO 2 large dose tablets for 1
or 2 days)
c. Metronidazole (IV or IM …..)
d. Miconazole ( PO …..)
e. Clindamycin (PO …..)
Lactational mastitis..Rx:
_ doxycycline
_ ciprofloxacin
_ ceftriaxon
_ gentamyecin
_ cephalexin
55y old female post menopausal need calcium daily to protect against
osteoprosis the daily intak?
a)200 gm
b)400 gm
c)1000 gm
d)1500 gm
1500 و حاجة مريضة سن اليأس1000 حاجة الحامل
pergnant woman in 10 week,,,come looks very ill ,,,dehydrated..dry mouth...skin
very dry...vomiting..& nothing become stable in stomach(seems to be like
(hyperemsis gravidrum
which u suspect to see in urine analysis
a...glucose
b..ketone.......sure,,,,,
c..leucocyte
d..protein
according to post partum bleeding mangment by using PG (hemabate)
which is relative contraindication
a..maternal HTN....
b..maternal asthma.
c..maternal diabetes
****Hemabate is (Carboprost Tromethamine)
56y old female with history of breast cancer what is the plan for protection from
?osteoprosis
a)estrogen replacement therapy
b)vit D &Ca
pregnant lady with hepatits, how to confirm dx :
a- ALP
B-SGOT
C-WBC
D-ESR
methyl-progesteron used for PPH what is contrindication :
a.Pregnant with asthma
b.Pregnant with hypertension
c.Pregnant with DM
patient came with cervical carcinoma next investigation :
-cone biopsy
- Direct biopsy
-pap smear
23 years old female with regular menses. On US, she has
a 7cm ovarian cyst. otherwise everything is normal. dx:
a. corpus luteum cyst
b.follicular cyst
c.teratoma
d.another cancer
young female complains of 6 weeks amenorrhea and history
of VP bleeding for many days and by laparoscopy the is free
fluid in douglas of pouch(I don't remember the exact NO.)
what is the most probable cause??
which of the following test should be used in evaluation pt at risk for HIV
a. VEDRL
b. eastren plot analysis
c. enzyme linked immunoassy
d. gonozyme test
28yrs old women has cx cytology smear report many severaly dyskaryot
cells and few frankly malignant cell what next step in managment;
A.repeat smear
B. cone biopsy
C.hytrectomy
D.D&C
E.colposcopy & biopsy
B) after vaginal hysterectomy the patient came with vaginal
bleeding the next step:
1) Suturing of vaginal fornices
2) Packing of the vagina
3) Fill urinary bladder to exert positive pelvic pressure
4) Laparotomy and search the source of bleeding
C) most series complication of sterilization using monopolar
electrocoagulation
1) Haemorrhage from mesosalpinx
2) Burn to the skin
3) Electric injury to the intestine
4) Clamping the round ligament rather than the tubes
most complications of laparoscopy is all except?
1) Hypercapnia
2) Emphysema to the peritoneal skin
3) Injury to common iliac vessels
4) Injury to posterior division of lumbosacral plexeus
E) ARDS all except:
1) hypoxia and acidosis
2) cortisol increase phospholipid production
3) appear ground glass appearance
4) positive expiration may help in treatment
F) vulvar atrophic ulcer shiny with well demarcated edges with
excoriation :
1) lichen planus
2) lichen sclerosis etrophica
3) vulvar intraepithelial neoplasia
• endometrioid,
• clear cell,
• Brenner,
• transitional cell,
• small cell,
• undifferentiated.
*** Chromosomal
rubell causes congenital anomaly at :
1) 6-8 weeks
2) 12-16 weeks
3) 20-23weeks
4) 25-32 weeks
*** Congenital rubella syndrome (CRS) can occur in a developing fetus of a pregnant
woman who has contracted rubella, usually in the first trimester. If infection occurs 0–28 days
before conception, the infant has a 43% chance of being affected. If the infection occurs 0–12
weeks after conception, the chance increases to 51%. If the infection occurs 13–26 weeks
after conception, the chance is 23% of the infant being affected by the disease. Infants are
not generally affected if rubella is contracted during the third trimester, or 26–40 weeks after
conception.
L) A patient had ovulation induction with IUI
(intrauterine insemination) for 3 cycles the next step ?
1) Repeat one more cycle
2) Repeat two more cycle
3) ART
4) Repeat 3 more cycles
treatment of ectopic pregnancy all except ?
1) Salpinectomy
2) Salpingo-ophorectomy
3) Linear salpingostomy
4) Milking of the tube if it is near to the fimbrial
end
5) Segmental removal of part of the tube
a patient with secondary infertility with no history of PID or endometriosis?
1) Chlamydial infection
2) Gonorrhea infection
3) Trichomonis vaginalis
O) a patient has two first degree relatives the best is:
1) Prophylactic oophorectomy
2) Follow up
3) Screening by ultrasound and CA 125
screening of female by HPV and cancer cervix was negative so rescreen after:
1) 6 months
2) 1 year
3) 2years
4) 3years
Q) Marshall-Marshetti Krantz operation
R) a pap smear showed low grade intraepithelial
neoplasia with HPV infection so next step:
1) Antibiotics and repeat pap smear
2) Coposcopy
3) Cone biopsy
4) Radical hysterectomy
S) a lateral ventriculomegally of 14 mm width all will be
done except :
1) Whole body check up by sonogram
2) CT scan
the percentage of Ovarian causes of infertile couple ?
1) 10%
2) 15%
3) 20%
4) 25%
U) HPV 16 and 18 in relation to cancer cervix in :
1) 25%
2) 50%
3) 80%
4) 99%
after radical hysterectomy catheter shouldm't be removed until the residual
volume is :
1) < 75 ml
2) 75-100 ml
3) 100-150 ml
4) 150-200 ml
after the delivery of full term fetus by pulling the cord a global mass descended
and blood pressure dropped to 70/40 so the best used in this condition:
1) Vaproate
2) Halothane
3) Nitrous oxide
4) Pantosal Na
***(( This is acase of Uterine inversion)) Halothane and
Nitroglycerine (100mcg to 200 mcg intravenously)have a higher success rate
patient with heart disease NIHA class 3 GA 32 weeks fully dilated and head on
perineum for 1 hour in occipito-anterior exhausted and unable to bear down, so
the next step :
1) C.S.
2) Use Ventouse
3) Use of Low forceps
4) Spontaneous delivery
which entitled in Fitz-Hugh Curtis syndrome:
1) Chlamydial infection
2) Gonorrhea
3) Candidiasis
4) Ovarian fibroma